Providers lament Senate bill keeps 'draconian' Medicaid cuts

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Long-term care provider groups expressed disappointment Thursday, lamenting that a revised version of Senate Republicans' healthcare proposal maintained “draconian” provisions from its original iteration.  If adopted, the bill would cut Medicaid spending by $772 billion over a decade.

The new “Better Care Reconciliation Act of 2017” preserves the major Medicaid-related provisions of the original bill that have caused providers concern since its introduction. These include shifting the program to a per-capita cap system. The only notable change is a provision that would lift the Medicaid cap in the event of a public health emergency, such as the Zika outbreak in Florida.

Leaving the original bill's “draconian” Medicaid provisions in place would “end Medicaid as we know it today,” LeadingAge said Thursday in a statement on its opposition to the legislation.

“The bill would convert the current state/federal cost sharing structure to a per capita cap or block grant, cutting hundreds of billions of dollars from the program and millions of people from coverage — dealing a severe blow to the social safety net,” the group said.

American Health Care Association/National Center for Assisted Living President and CEO Mark Parkinson also expressed his group's disappointment with the bill preservation of “major flaws.”

When the Medicaid growth rate's formula change is fully in place, it would cut an average of $600,000 per year from individual facilities. Reductions in provider taxes may also “wreak havoc on states budgets in the years to come,” Parkinson said, costing providers an additional $100,000 per facility each year.

“Combined, these two provisions will put many nursing centers under water just as states begin to experience substantial growth [in] the number of older adults who will need long-term services and supports,” he said.  

But those Medicaid changes may never come, Senate Majority Leader Mitch McConnell (R-KY) reportedly told lawmakers hesitant about backing the bill. One GOP lobbyist told The Washington Post on Thursday that McConnell has made attempts to “sell the pragmatists” on the legislation by suggesting the spendings cuts “will never happen.”

An updated Congressional Budget Office score on the bill is expected to arrive early next week, with a procedural vote expected to follow.